The title says it all, I guess. I have a friend who has a family history of blindness due to retina detachments--a history taking place in the first half of the twentieth century and earlier. Two years ago he had a partial detachment that was fixed with laser surgery. Now, he has floaters, and an appointment with the ophthalmologist tomorrow.

Meanwhile, can anybody help me to assuage his fear of going blind? I feel fairly confident that people with good health care just don't go blind from retina detachments anymore--the laser surgery fixes everything.

Approximately 90% of rhegmatogenous detachments can be initially repaired with one or a combination of these procedures. Sometimes, a scleral buckle is combined with a TPPV. If the retina does not reattach or detaches again after initial reattachment, it is usually due to the development of scar tissue on the surface of the retina and tractional forces within the vitreous cavity. If this happens following a scleral buckle procedure, it is often necessary to do a TPPV to repair the detachment. Sometimes, an intraocular gas bubble can be injected and the retina reattached following positioning. If a TPPV was done initially, it is often necessary to go back and do another TPPV to remove the new scar tissue and/or perform a scleral buckle. If a pneumatic retinopexy was the initial procedure, another pneumatic can be done or a scleral buckle or TPPV can be performed. As one can tell, there is no set way to repair a detachment and all the available procedures can be used in different combinations and sequences depending on the specific situation.

VISUAL RESULTS

The visual prognosis depends mainly on the pre-existing status of the retina before it detached. If the macula has not detached, the pre-existing vision will usually be retained following successful repair. However if the macula is detached and central vision is impaired by the detachment, there may be permanent loss of central vision even if the retina is successfully repaired. The longer the macula is detached, the more likely there will be loss of vision due to irreversible damage to the photoreceptor cells. In general, if the center of the macula is detached for more than 4-5 days, there will be significant loss of central vision following surgical reattachment.

Anectdotally, a friend of mine (over 65) suffered a retinal detachment, underwent surgery, and the dang thing broke loose again. He's lost the sight in that eye.

With reference to QtM's cite, perhaps the age of the person makes a difference.

My optician is always harassing me about whether I have seen floating specks, odd patches etc. Bad myopia is apparently a risk factor for detached retinas and they are red hot on catching it ASAP because otherwise blindness will result.

Bright flashes of light are also a warning sign of retinal detachments. Having a detachment should be considered essentially an emergency, as it's important to be seen early so that the ophthalmologist can determine what needs to be done and how quickly. This is especially true since symptoms can "go away" in a few days, only to come back soon with worsening vision.

IIRC, myopia is a risk factor for retinal detachment because one cause is your eyeball being "longer" than usual, which can cause the retina to be stretched out slightly. People who are nearsighted, especially extremely so, should be seeing an eye doctor once a year to be checked out - ophthalmologists are the doctors most trained in looking for this sort of problem, but skilled optometrists/opticians can catch various symptoms/early warning signs of various eye problems and refer you to a specialist. Other risk factors are age, eye injury, and (not surprisingly) a previous detachment.

IANAD but I work in an ophthalmology practice. And our retinal guy is one of the best in the world, and a leader in the field of macular degeneration.

It's fairly unusual that someone would go fully blind from a retinal detachment today. Retinal detachment is treatable when caught in progress. An untreated detachment may lead to permanent vision loss, but not necessarily blindness (think of the times you've accidentally caught your thumb in the lens while taking a photo, and imagine the thumb actually being in your vision, in black, forever).

However, people will sometimes ignore the warning signs, which include but are not limited to:

Streaks, sparkles, arcs or flashes of light.
Sudden onset or unusual number of "floaters".
The appearance that the vision is occluded in some way, such as a wall was raised, or a curtain was dropped, partially or fully "blocking" the vision.
Foggy, blurry vision that does not improve with blinking or use of artificial tears.
Abnormal light sensitivity (such as normal lighting causing physical pain).

It should be said that any change in vision needs to be addressed.

To lessen your friend's fears, just assure him that being aware of and recognizing the symptoms is the best weapon he has. Annual eye exams (or more often if the ophthalmologist recommends) are important. Diabetics need to be seen more frequently, as there is an increased risk of eye problems (diabetic retinopathy). And people who are very very nearsighted also need to have annual exams.

Moral of the story: Don't whine when the eye doctor gives you the dilating drops. That's the only good way to get a look at the retina.

One of my retinas seems to be close to becoming detached--but it's been that way for about 20 years now. I am very near-sighted, and I had a serious eye injury more than 30 years ago that probably knocked things a little loose, but the doctors just tell me that all we can do it wait for it to collapse, if it ever does. They've given me all the warning signs, and told me to treat it as an emergency if I ever see any of the signs. And I keep having my eyes dilated every year to have it looked at to see if the damage is getting worse. (It's been stable for 20 years now.)

About 9 or 10 years ago, I had my first ocular migraine, which scared me nearly to death--I was *sure* that my retina was collapsing, and I was home alone with my two kids, with hubby at work and no one to leave the kids with. I couldn't even see well enough to look up the doctor's phone number, and my kids were too young to read at all. I was able to call hubby and tell him to come home pronto, then he dialed the doctor's office for me. The person I spoke with was very nice, listened to my symptoms, and assured me that the condition was *not* a collapsed retina, and that it would go away on its own within a few hours.